Drug updated on 3/28/2024
| Dosage Form | Capsule (oral; 186 mg); Injection (intravenous; 372 mg) |
| Drug Class | Azole antifungals |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- For the treatment of adults with invasive aspergillosis or invasive mucormycosis.
Summary
- Isavuconazonium sulfate (Cresemba) is used for the treatment of adults with invasive aspergillosis or invasive mucormycosis.
- A total of 3 systematic reviews/meta-analyses were reviewed, providing insights into the effectiveness and safety profile of this drug in different patient populations.
- In patients with haematologic malignancies who are at high risk for developing invasive fungal infections (IFIs), evidence from eight studies suggests that isavuconazole may be effective for IFI prophylaxis. However, these studies often lacked safety data and were based on small patient populations from single centres.
- For lung transplant recipients, a network meta-analysis ranked isavuconazole among the top azole antifungals in preventing IA/IFI when used as part of universal prophylaxis post-transplantation. The certainty level was very low due to lack of robust data from randomized controlled trials.
- Comparing efficacy between isavuconazole and voriconazole in treating Aspergillus pathogens showed no relationship with clinical outcomes where MICs were less than 16 µg/ml for either drug. Reduced efficacy might occur against pathogens having drug MICs equal to or greater than 16 µg/ml.
- Despite promising results, further research including larger sample sizes across multiple centers are needed to confirm these findings about Cresemba's effectiveness and safety profile especially within high-risk hematologic populations.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Cresemba (isavuconazonium sulfate) Prescribing Information. | 2022 | Astellas Pharma US, Inc., Northbrook, IL |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| Effectiveness and safety of isavuconazole prophylaxis for invasive fungal infections in the haematologic setting. | 2022 | Hematology |
| Antifungal prophylaxis in adult lung transplant recipients: Uncertainty despite 30 years of experience. A systematic review of the literature and network meta-analysis. | 2022 | Transplant Infectious Disease |
| Clinical review report: isavuconazole (Cresemba). | 2019 | CADTH |
| Outcomes by MIC Values for Patients Treated with Isavuconazole or Voriconazole for Invasive Aspergillosis in the Phase 3 SECURE and VITAL Trials | 2018 | Antimicrobial agents and chemotherapy |